FLUTICASONE PROPIONATE DOES NOT INFLUENCE BONE METABOLISM IN CONTRASTTO BECLOMETHASONE DIPROPIONATE

Inhaled corticosteroids (ICS) in dosages above 1,000 mu g/d may influe nce parameters of bone metabolism. Fluticasone propionate (FP) is a ne w ICS with a higher clinical potency than beclomethasone dipropionate (BDP) combined with negligible oral bioavailability. The aim of this s tudy was to evaluate the effects of FP and BDP in clinically equipoten t dosages on indices of bone metabolism and morning cortisol. FP 750 m u g/d and BDP 1,500 mu g/d were compared in a randomized, double-blind , crossover study consisting of two 6-wk treatment periods, each prece ded by a 3-wk single-blind placebo period. Twenty-one nonsmoking asthm atics completed the study. FP had the same effect on FEV(1) and peak e xpiratory flow as the double dose of BDP. Both treatments did not chan ge morning cortisol. BDP decreased both osteocalcin and procollagen ty pe 1 carboxyterminal propeptide, indices of bone formation, significan tly by 18.5 and 21.9%, respectively. In contrast, FP did not change an y variable of bone formation. FP and BDP did not increase type 1 colla gen carboxyterminal telopeptide and deoxypyridinoline crosslinks, both markers of bone resorption. if changes in parameters of bone metaboli sm indicate adverse effects on bone quality in the long term, FP may o ffer an advantage over BDP.